• Knowledge of insurance, especially Medicare and Medicaid, rules and guidelines.
• Identify insurance company or proper party (patient) to be billed; identify and bill insurances
• Process claims as they are paid and credit accounts accordingly.
• Review insurance payments for accuracy an d compliance with contract discounts.
• Review denials or partially paid claims and work with the involved parties to resolve the discrepancy.
• Manage assigned accounts ensuring outstanding/pending claims are paid in a timely manner and contact appropriate parties to collect payment.
• Communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment.
• Consult supervisor, team members and appropriate resources to solve billing and collection questions and issues.
• Maintain work operations and quality by following standards, policies and procedures; escalate compliance issues to supervisor.
• Prepare reports and forms as directed and in accordance with established policies.
• Perform a variety of administrative duties including but not limited to: answering phones; faxing and filing of confidential documents; and basic internet and email utilization.
• Provide excellent and professional customer service to internal and external customers.
• Function as contributing team member while meeting deadlines and productivity standards.
• Customer service driven
• Must have 1 – 3 years medical collections and billing experience
• Understanding of medical terminology and insurance laws/guidelines
• Excellent organization and time management
• Strong team player
• Proficient in Windows based applications, and MS Office software products
• Ability to learn quickly, build and maintain long term relationships and work with minimal supervision
• Strong written and verbal communication skills; strong analytical, , organizationa